So, you’re expecting (congratulations!) and you’re planning to breastfeed. Fantastic! But have you considered how you’ll pump milk when you’re away from your baby? A breast pump can be a lifesaver, but they can also be expensive. Thankfully, the Affordable Care Act (ACA) mandates that most health insurance plans cover breast pumps and supplies.
This guide will walk you through everything you need to know about getting a breast pump through insurance, from eligibility to choosing the right pump for you. Let’s dive in!
How To Get A Free Breast Pump Through Insurance?: A Step By Step Guide
Getting a free breast pump through insurance is easier than you might think. Here’s a breakdown of the process:
Step 1: Check Your Insurance Coverage:
First things first, confirm if your insurance plan covers breast pumps. You can do this by:
- Reviewing your insurance plan documents.
- Calling your insurance company’s customer service line.
- Checking your insurance provider’s website (they often have a benefits section).
Step 2: Find Out About Specific Coverage Details:
Once you know your plan covers breast pumps, dig a little deeper. Here’s what you need to find out:
- Covered Brands and Models: Most plans have a list of approved breast pumps. You can usually find this information on your insurance company’s website or by calling them.
- Copays and Deductibles: There might be a copay or deductible associated with getting a breast pump. You’ll want to know these costs upfront.
- Supplier Network: Some insurance plans work with specific suppliers who handle breast pump orders.
Step 3: Get a Doctor’s Prescription (if needed):
While not always required, some insurance plans might need a doctor’s prescription for a breast pump. Talk to your doctor about getting one if your insurance company requires it.
Step 4: Choose Your Breast Pump:
With the covered models in hand, you can research and choose the pump that best suits your needs. Consider factors like:
- Type of pump: Electric single or double, manual, or hospital-grade (for specific situations).
- Portability: Do you need a pump for on-the-go use? Look for lightweight and wearable options.
- Features: Consider features like adjustable suction levels, noise level, battery life, cost and ease of use.
Step 5: Confirm Hospital Grade Pump Coverage:
- If needed, ask about the coverage for hospital-grade pumps, especially in specific medical situations like mastitis, lactation issues, congenital issues, multiple birth and a baby born preterm.
- Understand the conditions under which such pumps are eligible. For the above discussed medical conditions you will need a hospital grade.
Step 6: Learn About The Cost:
Before ordering the pump ask your provider about the additional costs and charges:
- Clarify if there are any out-of-pocket costs, deductibles, or co-payments associated with obtaining the breast pump.
- Get information on any additional costs, such as collection kits.
Step 7: Order Your Breast Pump:
Here’s where things can vary depending on your insurance plan:
- Direct from Supplier: Some plans allow you to order directly from a designated supplier. They’ll handle communication with your insurance and deliver the pump to your home. The common brands are Spectra, Medela, Momcozy, Elvie and Willow among others.
- Third-Party Providers: Certain insurance companies might work with third-party providers who specialize in breast pump orders. They’ll guide you through the selection and ordering process.
- Doctor’s Office: Occasionally, you might be able to get your pump directly through your doctor’s office, especially if they have a lactation consultant on staff.
Step 8: Track Your Order and Confirm Coverage:
Once you’ve placed your order, keep track of the delivery timeline. Additionally, double-check with your insurance provider to ensure everything is covered and there are no unexpected charges.
Finding the Best Breast Pump Through Insurance: Tips and Considerations
Remember, “best” is subjective! The ideal pump depends on your individual needs and lifestyle. Here are some tips:
- Read Customer Reviews: Look for online reviews of the covered pump models to get a sense of their functionality and user experience.
- Consider Your Needs: If you plan to pump frequently at work or on-the-go, a portable or wearable pump might be a good choice. If you have certain medical conditions then go for hospital grade breast pump.
- Talk to Your Doctor or Lactation Consultant: They can provide insights based on your specific situation and help you choose a pump that works for you.
Bonus Tip: Don’t be afraid to ask questions! Whether it’s to your insurance company, doctor, or a lactation consultant, getting all the information you need is vital.
Free Breast Pump Through Insurance: Does Brand Matter?
While insurance might cover some top brands, it doesn’t necessarily mean they’ll cover the absolute latest model. Focus on functionality and features that suit your needs. Here’s the good news: most covered pumps will be perfectly adequate for most breastfeeding moms. Please read below the top pumps covered by most of the insurance companies in the country.
Breast Pumps Through Medicaid: What You Need to Know
If you have Medicaid, you’re still eligible for a free breast pump through your insurance! The process might be slightly different, so it’s best to contact your Medicaid provider directly for specific details about covered pumps and the ordering process. I have discussed all these things in more detail in this article: Medicaid
Wearable Breast Pump Through Insurance: A Modern Option
Wearable breast pumps are a game-changer for busy moms. They offer hands-free, tubeless and wearable pumping allowing you to get things done while still expressing milk. But are they covered by insurance?
The short answer: It depends on your specific insurance plan. Here’s what you need to consider:
- Coverage Trends: Wearable pumps are a relatively new technology, and some insurance plans might not cover them yet. However, coverage is becoming more common. Some common and popular brands in wearable pumps are Elvie, Willow, and Momcozy and all of these are covered.
- Plan Details: Check your plan documents or call your insurance company to see if wearable pumps are included in their list of covered breast pumps.
Tips for Getting a Wearable Pump Through Insurance
- Advocate for Yourself: If your plan doesn’t currently cover wearable pumps, politely inquire about the possibility of coverage in the future.
- Consider Alternatives: If your plan doesn’t cover wearables, explore other covered pumps like Medela and Spectra that might still meet your needs.
Top Breast Pumps Through Insurance
Explore the coverage of leading breast pump brands under various insurance policies:
1. Elvie Breast Pump
Elvie Pump, a wireless and wearable electric breast pump, discreetly fits into your nursing bra. It’s priced at $549 for a double pump with a 2-year warranty and is designed for convenience. Save up to 40% on Elvie Pump. Known for smart breastfeeding solutions, Elvie works with DME suppliers to facilitate insurance coverage. Check with your insurance provider for eligibility. You can learn more about Elvie here.
2. Willow Breast Pump
Willow offers a wireless and wearable breast pump for seamless pumping. At $340 per single pump, it’s a premium choice covered by insurance. Save up to 40% through the insurance verification program. Select your pump and accessories, fill out the insurance form, and Willow’s partner will verify insurance. Your insurance-covered items ship free, ensuring a hassle-free experience. I have discussed Willow pump in detail here.
3. Ardo Breast Pump
Ardo presents an electric breast pump covered by insurance. Follow these easy steps for your Ardo pump:
- Obtain a prescription (you can choose Ardo at the DME of your choice).
- Have your insurance card ready.
- Visit ardo-usa.com, select “Free Breast Pump,” and complete the order form.
4. Lansinoh Breast Pumps
Lansinoh offers various breast pumps, most covered by insurance. Explore their range of reliable and insurance-friendly options. Obtain the necessary prescription and check with your insurance provider for smooth coverage.
5. Ameda Mya Breast Pump
Ameda Mya, a portable electric breast pump, may be covered by insurance. Under the Affordable Care Act, health insurance is mandated to cover breast pump costs. If your plan predates 2010, it might be considered “grandfathered” and exempt, but otherwise, a breast pump should be part of your covered healthcare. Most plans cover double electric pumps, and hospital-grade rental pumps may be an option based on specific needs. Discussing options with a representative helps navigate your coverage and devise a personalized plan.
6. Zomee Breast Pumps
Zomee Breast Pump – a versatile and efficient choice for nursing mothers. With features like customizable suction levels, three pumping modes, and a hygienic closed system, the Zomee pump is designed for comfort and convenience. Its portable design and USB-rechargeable battery make expressing milk a hassle-free experience, providing flexibility for on-the-go moms.
Check with your insurance company for potential coverage. Zomee’s pumps offer efficient pumping solutions, making them suitable for breastfeeding mothers.
You can read our in depth Zomee Fit Breast pump review.
7. Spectra S1 and S2 Breast Pumps
Spectra S1 and S2 are powerful electric breast pumps with potential insurance coverage. These hospital-grade pumps offer efficient pumping and may be available through insurance plans. This closed system pump facilitates both single and double pumping, offering a myriad of features in a compact unit weighing under 3 lbs.
With up to 270mmHg suction, 12 vacuum levels, and 5 Expression Cycles, it caters to breastfeeding moms, especially exclusive pumpers. The multi-phase “suckle” ensures comfort, while the customizable Massage Mode, equipped with 5 suction levels, aids in effective let-downs. BPA-free accessories, LCD screen display, built-in night light, timer, and a 2-year warranty make the Spectra S1 and 2 Plus an optimal choice for breastfeeding families and healthcare providers alike. Check with your insurance provider for details on coverage. More about Spectra S2 pump here.
FAQs About Getting Free Breast Pumps Through Insurance
Question: Can you really get a free breast pump through insurance?
Absolutely! Your health insurance plan is legally obligated to cover the cost of a breast pump without any co-pays. This includes all health insurance plans, even Medicaid.
Question: How to find out what breast pump is covered by insurance?
Simply input your insurance details and state of residence. This will reveal the breast pump options covered by your insurance at no cost and potential upgrades for an additional fee.
Question: What is the best breast pump to get through insurance?
The best pump varies based on personal preference. Explore top-quality options from Medela, Spectra, Willow, Lansinoh, Elvie, Motif, Ameda, and more – all accessible through insurance.
Question: What breastfeeding supplies are covered by insurance?
Insurance covers a range of supplies, including breast pumps, flanges, shields, and tubing. These essentials are part of the coverage provided by insurance companies.
Question: When should I order my free breast pump through insurance?
To ensure a stress-free experience, consider ordering your free breast pump in your third trimester or as early as six months before your due date. This allows ample time for processing and delivery.
Conclusion
Navigating the world of breast pumps and insurance can feel overwhelming. But with a little planning and research, you can get the free breast pump that best suits your breastfeeding journey. Remember, most importantly, choose a pump that makes you feel comfortable and confident!
Now that you’re armed with this knowledge, reach out to your insurance provider and get started on securing your free breast pump! Happy pumping!
